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Received Dec Many authors have used platinum-based agents, but with varying results. Ovarian Cancer Ovarian Cancer: Based on molecular studies, some mucinous borderline tumors of the ovary may actually represent metastasis from the appendix. Negava qualquer queixa gastrointestinal. Standard chemotherapy regimens for invasive ovarian cancer are used if any medical therapy is given. There has been much discussion as to ds conservative surgery, specifically, cystectomy, performed with laparoscopy could lead to higher relapse rates as compared with laparotomy, because of the increased risk of cyst rupture Collision tumors of the ovary associated with teratoma: Factors for bad BOT prognosis.

Surgical staging is based on operative findings, and consists in carrying out all procedures in the standardised clinical guides explained below [ 13 ], either in a first surgery or a second, if required, although there is a great deal of controversy around a second because it does not appear to affect patient survival [ 10 ]. Although none of these has been shown to be statistically significant, factors reportedly linked ovxrio borderline tumors include the following:.

In Sweden, the incidence of borderline tumors may be increasing, according to a study.

TUMOR BORDERLINE DE OVARIO DOWNLOAD

However, there is also the possibility of performing the radical surgery sooner because of the psychological xe produced by waiting for the relapse to occur, even risking recurrence in the form of an invasive tumour [ 14 ]. The purely mucinous tumors of the ovary are considered, by some authors, as a monodermic variant of mature teratoma. Diagnosis, treatment, and follow-up of borderline ovarian tumors. Radical surgery In postmenopausal women, and in those who have fulfilled their reproductive wishes, the following standardised procedures will be carried out: The importance of correct surgical staging lies in the need for a change in surgical treatment and postoperative adjuvant treatment if any added pathology is present.

Given the excellent prognosis for borderline ovarian tumors, hysterectomy and contralateral oophorectomy are not necessary if the ovary appears normal if the patient wishes to preserve fertility. However, the postoperative management protocol is far from clear. They are divided into two subtypes: The debate continues over the possibility of completing the surgery in patients first treated with conservative surgery, through resectioning of the ipsilateral ovarian remnant and of the contralateral ovary as soon as these patients fulfil their childbearing desires.

In patients whose recurrence was invasive carcinoma, the median time to diagnosis was 8. Sign Up It’s Free!

Management of borderline ovarian tumours: a comprehensive review of the literature

Kelly R, Scully RE. The definitive diagnosis dde histological. Mucinous BOT These tend to be larger than serous BOT and have either a unilocular or multilocular cystic structure, with fine septa in their interior and intramural nodules [ 3 ].

It is neither sensitive nor specific enough to be used as a screening tool in the normal populations. Gershenson and colleagues’ research indicated that the following factors had no effect on progression-free survival:. The risk and ed factors for the occurrence of BOT are similar to those of carcinoma; however, the association with mutations in BCRA genes is exceptional.

For women under the age of 40 who desire to have children and present with a BOT in stages II and III with peritoneal implantsthe surgical technique will vary according to the invasiveness of the implants:.

To date, no randomized data show a benefit. This seems to have some correlation with the hormonal levels achieved during ovarian stimulation and the damage caused by repeated gonadal punctures [ 13 ]. Choosing the best treatment for these patients is a real challenge. Lymphatic involvement, despite having no prognostic value in BOT, is an area associated with a recurrence or a progression to carcinoma, but this is exceptional and therefore justified by the morbidity associated with systematic lymphadenectomy in staging [ 316 ].

Langley FA, Fox H. When comprehensive staging was performed, no statistical difference was found in recurrence in confirmed cases of borderlihe I disease. Once the BOTs are completely removed surgically they may recur, and may be of the borderline type the majorityin which case survival is not affected, or of the invasive carcinoma type [ 212 ], in which case, the prognosis of these patients may be drastically affected.

Incomplete staging surgery as a major predictor of relapse of borderline ovarian tumor. This treatment will only be indicated for those patients with BOTs with a high risk of recurrence invasive implants, microinvasion, micropapillary patterns, or intracystic carcinoma [ 1 ].

The type of implant ie, invasive, noninvasive should be noted by pathology, as it has significant prognostic value. Response to the usual cytotoxic agents is low, probably related to the oavrio proliferation of these tumours. Although not routine, static DNA cytometry can be performed on biopsy specimens. In patients with stage II-IV disease, the prognosis is different; an increased stage is associated with a worse prognosis and only age at diagnosis and the presence of invasive implants are shown to influence prognosis.

Borderline Ovarian Cancer Borderline Tumor Overview

Treatment Parameters The accepted initial treatment of borderline ovarian tumors is surgical removal of the tumor and the performance of biopsies. The purely mucinous tumors of the ovary are considered, by some authors, as a monodermic variant of mature teratoma. In another study, which looked at 25 women who underwent fertility-sparing surgery, no recurrences took place in the study period, although the range of follow-up varied widely mo.

However, the investigators were not able to identify any key imaging characteristics that would distinguish borderline tumors from other ovarian tumors. Comprehensive debulking and staging decreases the chance of a sampling error that could result in an inaccurate diagnosis and prognosis.

Younger women are more likely to be diagnosed with a BOT than with ovarian carcinoma, and their prognosis and global survival rates are much higher in comparison. Am J Surg Pathol ; The less common endometrioid tumor of low malignant potential should not be regarded as malignant because it seldom, if ever, metastasizes. Epithelial multilayering of more than 4 cell layers. Abstract Borderline ovarian tumours differ from epithelial ovarian cancer by their low incidence, frequent association with infertility, low association with mutations in BCRA genes, different percentages of the most common histological types, early stage diagnosis, and high survival rate, even when associated with peritoneal involvement.

Slideshow in Review: In patients with recurrence, a median time to diagnosis of 3.